Provider Demographics
NPI:1316354624
Name:RUSZKOWSKI, CARLA (MS,BCBA)
Entity type:Individual
Prefix:MS
First Name:CARLA
Middle Name:
Last Name:RUSZKOWSKI
Suffix:
Gender:F
Credentials:MS,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2583 SUNNYKNOLL AVE
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-1530
Mailing Address - Country:US
Mailing Address - Phone:248-410-2535
Mailing Address - Fax:248-331-9919
Practice Address - Street 1:2583 SUNNYKNOLL AVE
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-1530
Practice Address - Country:US
Practice Address - Phone:248-410-2535
Practice Address - Fax:248-331-9919
Is Sole Proprietor?:No
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst